PHARM 101 EXAM 1 COMPLETE STUDY
GUIDE Pharmacology Fundamentals |
NCLEX-Style Q&A with Rationales &
Calculations
SECTION 1: PHARMACOKINETICS (ADME)
Question 1. What are the four phases of pharmacokinetics that a drug goes through in the
body?
A. Absorption, distribution, metabolism, excretion
B. Administration, digestion, metabolism, elimination
C. Absorption, distribution, methylation, excretion
D. Assimilation, distribution, metabolism, excretion
Answer: A
Rationale: Pharmacokinetics involves four processes: Absorption (how drug enters
bloodstream), Distribution (how drug reaches tissues), Metabolism (how drug is broken down,
primarily in liver), and Excretion (how drug leaves the body, primarily via kidneys) .
Question 2. What is the first-pass effect?
A. The process where drugs are excreted unchanged in urine
B. The metabolism of an oral drug by the liver before it reaches systemic circulation
C. The binding of a drug to plasma proteins
D. The initial dose of a medication given to achieve therapeutic levels quickly
Answer: B
Rationale: The first-pass effect refers to the significant metabolism of orally administered drugs
by the liver before they enter systemic circulation. This reduces bioavailability and explains why
some drugs (e.g., nitroglycerin) cannot be given orally .
, Question 3. A patient with liver failure is admitted. What nursing action is most appropriate
before administering any medications?
A. Administer medications as ordered, no change needed
B. Check drug dosing schedules because reduced liver function may require lower doses
C. Increase all medication doses due to decreased metabolism
D. Hold all medications until liver function tests normalize
Answer: B
Rationale: The liver is the primary site of drug metabolism. In liver failure, drug metabolism is
impaired, leading to drug accumulation and toxicity. The nurse should review dosing schedules
and consult with the provider about potential dose reductions .
Question 4. Which body system, if altered, would most drastically affect pharmacokinetics?
A. Cardiovascular system
B. Renal system (kidneys)
C. Endocrine system
D. Respiratory system
Answer: B
Rationale: The renal system is primarily responsible for drug excretion. Impaired kidney
function leads to drug accumulation and toxicity. Many drugs require dose adjustments based
on creatinine clearance. The liver (metabolism) and kidneys (excretion) are the two most critical
organs affecting pharmacokinetics .
Question 5. Why is monitoring peak and trough drug levels important for certain medications?
A. To determine if the patient is allergic to the medication
B. To ensure drug levels remain within therapeutic range without toxicity
C. To calculate the total daily dose needed
D. To measure how fast the drug is absorbed from the GI tract
Answer: B
Rationale: Peak level indicates the highest concentration of drug in the blood, while trough
level is the lowest concentration just before the next dose. Monitoring these levels ensures
GUIDE Pharmacology Fundamentals |
NCLEX-Style Q&A with Rationales &
Calculations
SECTION 1: PHARMACOKINETICS (ADME)
Question 1. What are the four phases of pharmacokinetics that a drug goes through in the
body?
A. Absorption, distribution, metabolism, excretion
B. Administration, digestion, metabolism, elimination
C. Absorption, distribution, methylation, excretion
D. Assimilation, distribution, metabolism, excretion
Answer: A
Rationale: Pharmacokinetics involves four processes: Absorption (how drug enters
bloodstream), Distribution (how drug reaches tissues), Metabolism (how drug is broken down,
primarily in liver), and Excretion (how drug leaves the body, primarily via kidneys) .
Question 2. What is the first-pass effect?
A. The process where drugs are excreted unchanged in urine
B. The metabolism of an oral drug by the liver before it reaches systemic circulation
C. The binding of a drug to plasma proteins
D. The initial dose of a medication given to achieve therapeutic levels quickly
Answer: B
Rationale: The first-pass effect refers to the significant metabolism of orally administered drugs
by the liver before they enter systemic circulation. This reduces bioavailability and explains why
some drugs (e.g., nitroglycerin) cannot be given orally .
, Question 3. A patient with liver failure is admitted. What nursing action is most appropriate
before administering any medications?
A. Administer medications as ordered, no change needed
B. Check drug dosing schedules because reduced liver function may require lower doses
C. Increase all medication doses due to decreased metabolism
D. Hold all medications until liver function tests normalize
Answer: B
Rationale: The liver is the primary site of drug metabolism. In liver failure, drug metabolism is
impaired, leading to drug accumulation and toxicity. The nurse should review dosing schedules
and consult with the provider about potential dose reductions .
Question 4. Which body system, if altered, would most drastically affect pharmacokinetics?
A. Cardiovascular system
B. Renal system (kidneys)
C. Endocrine system
D. Respiratory system
Answer: B
Rationale: The renal system is primarily responsible for drug excretion. Impaired kidney
function leads to drug accumulation and toxicity. Many drugs require dose adjustments based
on creatinine clearance. The liver (metabolism) and kidneys (excretion) are the two most critical
organs affecting pharmacokinetics .
Question 5. Why is monitoring peak and trough drug levels important for certain medications?
A. To determine if the patient is allergic to the medication
B. To ensure drug levels remain within therapeutic range without toxicity
C. To calculate the total daily dose needed
D. To measure how fast the drug is absorbed from the GI tract
Answer: B
Rationale: Peak level indicates the highest concentration of drug in the blood, while trough
level is the lowest concentration just before the next dose. Monitoring these levels ensures
